Provider Demographics
NPI:1730647017
Name:DILLARD, TRINA MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:MARIE
Last Name:DILLARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:FORTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46040-1018
Mailing Address - Country:US
Mailing Address - Phone:317-503-7620
Mailing Address - Fax:
Practice Address - Street 1:9650 COMMERCE DR STE 531
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7639
Practice Address - Country:US
Practice Address - Phone:317-565-3717
Practice Address - Fax:317-334-0041
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003457A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health